| National Provider Identifier [NPI]: | 1255391389 |
| Last Name Of The Provider | KERIN |
| First Name Of The Provider | DOUGLAS |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 209 S PORTLAND AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | RUSSELLVILLE |
| Zip Code Of The Provider | 728012339 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 199 |
| Number Of Services | 7941 |
| Number Of Medicare Beneficiaries | 3985 |
| Total Submitted Charge Amount | 904487 |
| Total Medicare Allowed Amount | 237918.81 |
| Total Medicare Payment Amount | 181065.69 |
| Total Medicare Standardized Payment Amount | 194865.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 199 |
| Number Of Medical Services | 7941 |
| Number Of Medicare Beneficiaries With Medical Services | 3985 |
| Total Medical Submitted Charge Amount | 904487 |
| Total Medical Medicare Allowed Amount | 237918.81 |
| Total Medical Medicare Payment Amount | 181065.69 |
| Total Medical Medicare Standardized Payment Amount | 194865.19 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 926 |
| Number Of Beneficiaries Age 65 to 74 | 1426 |
| Number Of Beneficiaries Age 75 to 84 | 1082 |
| Number Of Beneficiaries Age Greater 84 | 551 |
| Number Of Female Beneficiaries | 2481 |
| Number Of Male Beneficiaries | 1504 |
| Number Of Non Hispanic White Beneficiaries | 3812 |
| Number Of Black or African American Beneficiaries | 62 |
| Number Of AsianPacific Islander Beneficiaries | 14 |
| Number Of Hispanic Beneficiaries | 67 |
| Number Of American Indian Alaska Native Beneficiaries | 12 |
| Number Of Beneficiaries With Race Not Else where Classified | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2680 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1305 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.3789 |